Circulatory Death, Brain-Dead Donor Kidneys Offer Equivalent Outcomes

SAN FRANCISCO—Patients who receive kidneys from donors after circulatory death and donors after brain death have equivalent outcomes, but recipients of circulatory-death kidneys have a higher rate of delayed graft function (DGF), according to study findings presented at the 2014 World Transplant Congress.

Stephen P. McDonald, MBBS, from the Royal Adelaide Hospital in South Australia, and his colleagues compared graft survival and function in 2,976 kidney transplant recipients performed from 2007 to 2012.

Of these patients, 542 (18%) received kidneys from donation after circulatory death (DCD) donors and 2,434 (82%) received kidneys from donation after brain death (DBD) donors.

Graft and patient survival and rejection rates were similar in both groups, but DGF requiring dialysis post-transplant occurred significantly more frequently in the DCD group (53% vs. 20%). In addition, DCD kidney recipients had significantly lower estimated glomerular filtration rates at 1, 2, 3, 6, and 12 months, but the size of the difference decreased progressively after transplantation.

DCD and DBD donors were of similar age, but the DCD donors were significantly more likely to be male (70% vs. 55%) and to die from trauma instead of medical causes.